Forms and Paperwork
Contact me:
Julie Wells LCSW, CP, TEP
26133 US HWY 19 N #310
Clearwater, FL 33763
Phone: (727) 688-5800
Fax: (727) 286-9640
SW9966
For counseling services
If you're a new client, and already have an appointment scheduled, please complete the following forms and bring them to your first therapy session along with your insurance card, if applicable, and a drivers license, or other form of identification.
Print, Read, and Complete all of these forms prior to your first therapy session.
Thank you in advance!
(please fill one form per adult entering couples/family therapy).
Other Important Forms:
To coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize contact.
Journey Into Wellness Counseling
Julie Wells LCSW, CP, TEP
offering telehealth and in-person sessions
**TEMPORARY
CONTACT #
727-788-7766**
Mailing Address:
PO Box 464
Crystal Beach, FL 34681
